European Journal of Pediatrics最新文献

{"title":"Variation in management of febrile infants younger than 90 days across London: a retrospective cohort study.","authors":"Stephanie Habermann, Rose Hartzenberg, Eva M Loucaides, George Lawson, Dominic Carr, Ian Maconochie, Ruud G Nijman","doi":"10.1007/s00431-026-06938-y","DOIUrl":"https://doi.org/10.1007/s00431-026-06938-y","url":null,"abstract":"<p><p>Evaluate variation in care of febrile infants presenting to London hospitals and adherence to national Clinical Practice Guidelines (CPGs). Retrospective multicentre cohort study conducted at 21 London hospitals. Infants ≤ 90 days of age presenting with fever or caregiver reported fever between 1st April 2021-31st March 2022 were included. Outcome measures were variations in patient management and adherence to national CPGs. Of 2,008 presentations, 41.1% were febrile during assessment. 73.7% had blood tests (range across hospital sites: 55.4-96.7%), 40.8% had cerebrospinal fluid (CSF) testing (17.1-70.7%), 63.4% had urinalysis (43.4-85.4%) and 62.2% were investigated for SARS-CoV2 (26.5-91.7%). Antibiotics were started in 57.7% (35.4-90.2%) and 63.5% (46.7-99.2%) were admitted. Infants aged < 28 days and infants febrile during assessment were more likely to undergo investigations and be admitted. Adherence varied significantly across sites: full adherence to CPGs was achieved in 21.9% (site range 8.8-35.4%), partial adherence in 24.4% (18.0-35.3%), non-adherence in 31.2% (10.6-47.4%), and over-adherence in 23.5% (8.0-44.7%). CPG adherence was higher in infants aged < 28 days.Conclusions: There was wide variation in care across London hospitals with limited adherence to guidelines. This highlights the need to focus on refining and updating decision models and CPGs, with more specific recommendations for managing infants who are afebrile during initial assessment. Clear guidance with a focus on reducing missed diagnosis may impact patient safety and economical expenditure.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of telitacicept in IgA vasculitis nephritis: a single-center retrospective study.","authors":"Tiantian Liu, Xinxin Sun, Chaozhen Xiao, Jinyue Li, Xuguang Gao, Hang Su, Pengfei Li, Miao Jiang, Lulu Fan, Ting Guo, Qingyin Guo","doi":"10.1007/s00431-026-07037-8","DOIUrl":"https://doi.org/10.1007/s00431-026-07037-8","url":null,"abstract":"<p><p>The objective was to evaluate the clinical efficacy and safety of telitacicept in the treatment of pediatric IgA vasculitis nephritis (IgAVN). A retrospective analysis was conducted on clinical data from patients aged 3-18 years with IgAVN treated with telitacicept at the Department of Pediatrics, The First Affiliated Hospital of Henan University of Chinese Medicine, between August 2023 and August 2024. Laboratory parameters were assessed at baseline and at 1, 3, 6, and 12 months posttreatment to determine therapeutic efficacy and safety. A total of 16 patients were enrolled (7 males [43.75%]; mean age 14.3 years). The median disease duration from diagnosis to telitacicept initiation was 4.25 (2.06-33.00) months, and the mean treatment duration was 8.63 ± 1.89 months. Early clinical improvement was observed as early as 1 month compared with baseline, characterized by substantial reductions in 24-h urinary protein (24 h-UP) and urinary red blood cell counts compared to baseline. At 12 months, mean 24 h-UP decreased further to 0.16 ± 0.15 g (P < 0.001), with 68.75% (11/16) of patients achieving complete remission. Serum IgG, IgM, and IgA levels were significantly reduced (P < 0.05), while serum albumin significantly increased (P < 0.001). No serious adverse events occurred; three patients experienced mild upper respiratory tract infections that resolved with symptomatic treatment.</p><p><strong>Conclusion: </strong> Telitacicept effectively reduces proteinuria, improves renal function, and enhances clinical remission rates in pediatric IgAVN, demonstrating a favorable safety profile.</p><p><strong>What is known: </strong>• Telitacicept, a dual BAFF/APRIL inhibitor, has shown potential effi cacy in IgA nephropathy (IgAN) and IgA vasculitisnephritis (IgAVN), particularly in reducing proteinuria and maintaining stable renal function. • Evidence regarding the use of telitacicept in pediatric IgAVN remains limited and is mainly derived from small case series and retrospective studies.</p><p><strong>What is new: </strong>• This study provides real-world data on the use of telitacicept in pediatric IgAVN, showing improvement in proteinuria with stable renal function during follow-up. • Most patients were able to discontinue glucocorticoids and/or immunosuppressive agents within 3-6 months after telitacicept initiation, suggesting a potential steroid- and immunosuppressant-sparing effect.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonographic optic nerve sheath diameter for predicting elevated intracranial pressure and clinical severity in children: a prospective observational study.","authors":"Md Naseem, Varun Anand, Rishika Das, Santosh Rathia","doi":"10.1007/s00431-026-07053-8","DOIUrl":"https://doi.org/10.1007/s00431-026-07053-8","url":null,"abstract":"<p><p>Elevated intracranial pressure (ICP) can complicate various neurological conditions in children and may result in fatal brainstem herniation. Early detection and management can prevent this fatal complication. This prospective observational study conducted over 18 months aimed to evaluate point-of-care ultrasound (POCUS) as a noninvasive, efficient method to detect elevated ICP in children aged less than 14 years. The primary objective of this study is to determine optic nerve sheath diameter (ONSD) values in children, measured by POCUS, and correlate them with the clinical severity of ICP. Secondary objectives include establishing age-specific ONSD values for diagnosing and predicting ICP severity, determining normal ONSD values from age-matched control groups, and estimating ONSD changes in response to hyperosmolar therapy. This study found a significant increase in ONSD in children with raised ICP compared to controls (5.63 mm vs. 4.35 mm), with consistent measurements across different locations. However, ONSD did not correlate with the clinical severity of ICP. While age moderately influenced ONSD in healthy children, it had no significant impact in those with raised ICP. The age-specific cut-off values for POCUS-measured ONSD (e.g., 4.91 mm for 1.5-10 years and 5.27 mm for 10-14 years) exhibited high sensitivity and specificity for detecting raised ICP. Furthermore, both hypertonic saline and mannitol effectively reduced ONSD, with no significant difference in their efficacy, suggesting both are viable options for managing raised ICP.</p><p><strong>Conclusion: </strong>This study establishes POCUS-measured ONSD as a reliable tool for detecting raised ICP in children. While more research is needed for age-specific norms and severity prediction, ONSD shows promise as a valuable adjunct in pediatric ICP management.</p><p><strong>What is known: </strong>• Optic nerve sheath diameter (ONSD) is a validated noninvasive marker for detecting intracranial hypertension in children.</p><p><strong>What is new: </strong>• ONSD does not correlate with the clinical severity of intracranial pressure, limiting its use as a quantitative stratification tool.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Real-world use of Serial Clinical Observation in culture-proven early-onset sepsis: timing of recognition, treatment and retrospective comparison with the Neonatal Sepsis Calculator.","authors":"Francesca Miselli, Licia Lugli, Giorgia Dragone, Luca Bedetti, Sofia Spinedi, Mariagrazia Capretti, Lucia Marrozzini, Luisa Di Luca, Silvia Fanaro, Lucia Gambini, Giacomo Biasucci, Giancarlo Piccinini, Davide Scarponi, Irene Papa, Francesca Nanni, Lorenza Baroni, Rossella Pagano, Valeria Capone, Alberto Berardi","doi":"10.1007/s00431-026-07005-2","DOIUrl":"https://doi.org/10.1007/s00431-026-07005-2","url":null,"abstract":"","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macroscopic hematuria in children with autosomal dominant polycystic kidney disease - report from four European tertiary centers.","authors":"Tomáš Seeman, Květa Bláhová, Filip Fencl, Ulrike John-Kroegel, Friederike Weigel, Terezie Šuláková, Ludmila Podracká, Janusz Feber","doi":"10.1007/s00431-026-07022-1","DOIUrl":"https://doi.org/10.1007/s00431-026-07022-1","url":null,"abstract":"<p><p>In adults with autosomal dominant polycystic kidney disease (ADPKD), episodes of macroscopic hematuria are relatively common and are predictors of hypertension. We hypothesized that a history of macroscopic hematuria will be associated with hypertension also in children with ADPKD. We retrospectively analyzed 289 children (median age 10.2 years) with ADPKD who were followed in four European tertiary nephrology centers. The presence of ≥ 1 episode of macroscopic hematuria (MaHu) defines a group of MaHu+ patients; the absence defines a group of MaHu- patients. Hypertension was defined as the use of antihypertensive drugs upon the last investigation. Macroscopic hematuria occurred in 7.2% of children (n = 21). It was the second most frequent presenting symptom of ADPKD (11 out of 51 children). The etiology of macroscopic hematuria included ruptured cyst, urinary tract infection or urolithiasis. The prevalence of hypertension at the last follow-up in MaHu+ children was significantly higher than in MaHu- children (14.3% vs. 3.1%, p = 0.017). The proportion of patients with elevated blood pressure ≥ 75th percentile was significantly higher in patients with hematuria as compared with patients with no hematuria (95% vs. 64%, p = 0.002). Children from the MaHu+ group had a significantly higher number of cysts when compared to the MaHu- group (20 vs. 10 cysts, p = 0.038). There were no significant differences between MaHu+ vs. MaHu- groups in other variables.</p><p><strong>Conclusion: </strong> In children with ADPKD, a history of macroscopic hematuria is associated with an increased risk of developing hypertension and/or elevated blood pressure.</p><p><strong>What is known: </strong>• Adults with autosomal dominant polycystic kidney disease have often episodes of macroscopic hematuria that predict development of hypertension.</p><p><strong>What is new: </strong>• In children with autosomal dominant polycystic kidney disease, macroscopic hematuria is rare but is also associated with an increased risk of developing hypertension.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-asphyxia acute kidney injury in neonates: a systematic review.","authors":"Temilade Aderounmu, Babatunde Adeyemi, Aisha Bolarinwa","doi":"10.1007/s00431-026-07021-2","DOIUrl":"https://doi.org/10.1007/s00431-026-07021-2","url":null,"abstract":"<p><p>Perinatal asphyxia is a major cause of neonatal morbidity and mortality globally. It affects multi-systems and has significant renal consequences. Acute kidney injury (AKI) is a frequent complication of perinatal asphyxia; however, its burden, diagnosis, and outcomes remain variably characterized. This study employed a scoping review approach to map and synthesize the existing evidence on post-asphyxia AKI in neonates. A total of 30 studies published between 1995 and 2025 were included, encompassing different geographic regions, study designs, and diagnostic criteria. The review demonstrates a clear growth in scholarly attention to post-asphyxia AKI, particularly in the last 25 years, coinciding with the introduction of neonatal-modified KDIGO definitions and advances in neonatal nephrology. Reported incidence of AKI varied widely, ranging from 20% to over 60%, reflecting non-homogeneity in study populations, differing case definitions of acute kidney injury in neonates, the severities of hypoxic-ischemic encephalopathy, and varied methodological approaches. Findings consistently indicate that AKI is strongly associated with severe forms of perinatal asphyxia, the presence of multi-organ dysfunction, prolonged neonatal intensive care stay, and mortality.</p><p><strong>Conclusion: </strong> Despite emerging interest in novel biomarkers and standard definitions, important gaps persist in early detection, long-term renal outcome data, and evidence from low- and middle-income countries. Addressing these gaps through standardized monitoring, biomarker validation, and longitudinal follow-up will improve renal survival in neonates affected by perinatal asphyxia.</p><p><strong>What is known: </strong>• The newborn kidneys are susceptible to the hemodynamic changes that follow ischemia/asphyxia due to a poor functioning capacity and oftentimes an inadequate structural potential. • Neonatal AKI is closely linked to severe forms of asphyxia, increased length of hospital stay and increased mortality. its reported incidence is widely varied.</p><p><strong>What is new: </strong>• The emergence of novel biomarkers in the identification and diagnosis of neonatal AKI, and the uptake and application of standard definitions (modified neonatal KDIGO) in the identification of neonatal AKI. • The availabiltiy of specialized kidney support therapy (continuous kidney replacement therapy; the carpadiem) in the management of neonatal AKI.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal concern and refusal toward neonatal heel-prick screening: a cross-sectional survey from Türkiye.","authors":"Hatice Turgut, Gülseda Boz, Tuba Güven, Ramazan Özdemir","doi":"10.1007/s00431-026-07025-y","DOIUrl":"10.1007/s00431-026-07025-y","url":null,"abstract":"<p><p>Neonatal heel-prick screening is a key component of preventive healthcare, and its effectiveness is strongly influenced by parents' knowledge, perceptions, and willingness to engage in screening. The aim of this study was to evaluate the relationships between mothers' sociodemographic characteristics and their attitudes and behaviors toward the screening process and the level of concern they experience regarding newborn screening. This cross-sectional study included 350 mothers. Data on sociodemographic characteristics and knowledge, attitudes, and behaviors regarding neonatal heel-prick screening were collected using a researcher-developed structured questionnaire. Maternal concern, defined as a self-reported binary outcome (present/absent), was the primary outcome variable. Associations were analyzed using the chi-square test or Fisher's exact test, as appropriate, and variables with p < 0.10 in univariable analyses were entered into a multivariable Firth's penalized logistic regression model. The results are presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs), and a two-sided p value < 0.05 was considered to indicate statistical significance. Among 350 mothers, 17.7% reported concern related to the heel-prick test, and 9.7% refused the procedure. Concern was more common among those who refused the test (73.5% vs. 11.7%, p < 0.001) and those with vaccine concern (42.5% vs. 5.9%, p < 0.001). According to the results of the multivariable analysis, vaccine concern was the strongest independent predictor (aOR = 8.98; 95% CI: 4.56-18.69; p < 0.001), whereas rural residence (aOR = 3.18; p = 0.032) and perceiving the procedure as painful (aOR = 4.70; p < 0.001) were also significant risk factors.</p><p><strong>Conclusion: </strong> This study revealed that maternal concern about heel-prick screening was associated with insufficient knowledge, negative perceptions of the procedure, concerns about the vaccine, rural residence, and cultural factors. These findings suggest that clear communication, effective education, and culturally sensitive counselling may help reduce maternal concern and improve participation in newborn screening programs.</p><p><strong>What is known: </strong>• Parental knowledge, perceptions, and communication with healthcare professionals are important determinants of participation in newborn screening programs.</p><p><strong>What is new: </strong>• Maternal concern toward neonatal heel-prick screening was independently associated with vaccine concern, perceived procedural pain, and rural residence, highlighting the need for targeted and culturally sensitive counselling.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome and epilepsy following neonatal stroke in the Italian Registry of Infantile Thrombosis.","authors":"Stefano Sartori, Margherita Nosadini, Gloria Brigiari, Andrea Francavilla, Thomas Foiadelli, Daniele Veraldi, Agnese Suppiej, Rossana Bagna, Susanna Casellato, Virginia Cao, Laura Baggio, Marta Conti, Daniela Farinasso, Patrizia Accorsi, Duccio Maria Cordelli, Mariella Magarotto, Michela Massoud, Veronica Pegoraro, Maria Federica Pelizza, Paola Saracco, Vittoria Arena, Elisa Ballardini, Alessandra Falcone, Marcella Gaffuri, Diletta Gentile, Alessandro Iodice, Anna Rosati, Samuela Bugin, Elisabetta Chiodin, Veronica Fogliani, Paola Freschi, Maurizio Radicioni, Elena Cavaliere, Irene Toldo, Claudio Ancona, Luca Capato, Jacopo Norberto Pin, Isotta Guidotti, Martina Lombardini, Matteo Luciani, Paolo Simioni","doi":"10.1007/s00431-026-06912-8","DOIUrl":"10.1007/s00431-026-06912-8","url":null,"abstract":"<p><p>The perinatal period is a high-risk time for stroke, with possible lifelong effects. We aimed at identifying factors associated with long-term neurological outcomes and post-stroke epilepsy in patients with neonatal arterial ischemic stroke (NAIS). We analyzed patients with NAIS from the Italian Registry of Infantile Thrombosis (RITI). Associations between clinical variables and outcomes (neurological deficits and epilepsy at last follow-up) were evaluated using univariate logistic regression. Among the 181 patients included (56.2% male), seizures were the most common initial symptom (79.4%). Stroke was left-sided in 62.0%, and bilateral in 15.0%; multiple lesions were reported in 32.5%. The middle cerebral artery territory was most frequently involved. One patient had a new infarction during hospitalization, and one died. At follow-up (median 21 months), no further recurrences or deaths occurred; neurological deficits were reported in 38.8%, and post-stroke epilepsy in 12.0% (among these latter, prior acute seizures occurred in 86.7%). At univariate regression, factors significantly associated with long-term neurological deficits were higher maternal age (p = 0.031); urgent cesarean (p < 0.001); lower gestational age (p = 0.033); neurological deficits at discharge (p < 0.001); seizures at last follow-up (p = 0.008). Factors significantly associated with post-stroke epilepsy were need for acute-phase assisted ventilation (p = 0.001); radiological brainstem involvement (p = 0.037); and longer admission duration (p = 0.050).</p><p><strong>Conclusion: </strong> Mortality and recurrence after NAIS are rare, but neurological deficits occur in about 40%, and epilepsy in 12%. Perinatal and clinical factors may predict adverse outcomes and epilepsy.</p><p><strong>What is known: </strong>• The perinatal period is a high-risk window for neonatal arterial ischemic stroke (NAIS), with seizures as the most common presenting symptom. Mortality and recurrent strokes after NAIS are rare, but long-term neurological deficits and post-stroke epilepsy are recognized complications.</p><p><strong>What is new: </strong>• In this registry-based cohort, specific perinatal and clinical factors-such as higher maternal age, urgent cesarean delivery, lower gestational age, neurological deficits at discharge, and seizures at follow-up-were significantly associated with long-term neurological impairments. • Risk factors for post-stroke epilepsy were identified, including need for acute-phase assisted ventilation, radiological brainstem involvement, and longer hospital stays, providing new insights for early prognostication and follow-up strategies.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonographic evaluation of suprahyoid muscle thickness during the transition to full oral feeding in preterm infants.","authors":"Saime Sundus Uygun, Busra Gokyer, Mehmet Ozturk, Evrim Kilicli, Osman Selcuk Duysak, Murat Konak","doi":"10.1007/s00431-026-07019-w","DOIUrl":"10.1007/s00431-026-07019-w","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The transition to full oral feeding (FOF) is a critical milestone for discharge in preterm infants and reflects the maturation of multiple physiological systems, particularly swallowing-related neuromuscular coordination. Suprahyoid muscles play a key role in swallowing by enabling elevation of the hyoid-laryngeal complex and protecting the airway. However, the relationship between the structural development of these muscles and the achievement of oral feeding in preterm infants remains insufficiently explored. This prospective single-center observational study included 28 preterm infants born at ≤ 32 weeks of gestation. Suprahyoid muscle thickness (right and left digastric, right and left mylohyoid, and geniohyoid muscles) was measured by ultrasonography at two time points: within the first 72 h of postnatal life and at the time of full oral feeding. Somatic growth parameters, including body weight, body length, and head circumference, were recorded simultaneously. Changes in muscle thickness over time, correlations with somatic growth parameters, and the predictive value of early muscle thickness for time to achieve FOF were analyzed. All suprahyoid muscle thicknesses increased significantly between the early postnatal period and the time of FOF (all p &lt; 0.001). At the time of FOF, digastric muscle thickness ranged approximately between 2.7 and 3.2 mm, mylohyoid muscle thickness between 1.6 and 2.0 mm, and geniohyoid muscle thickness between 3.0 and 3.6 mm, with values appearing to cluster within a relatively narrow range during successful transition to oral feeding. A positive correlation was observed between body weight and certain muscle thickness measurements, particularly left mylohyoid (r = 0.453, p = 0.015) and right digastric muscles (r = 0.386, p = 0.043). However, suprahyoid muscle thickness measured within the first 72 h did not independently predict the time required to achieve FOF in multivariable regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt; Suprahyoid muscle thickness increases significantly during the transition from early postnatal life to full oral feeding in preterm infants and appears to cluster within a relatively narrow range at the time of feeding maturation. Ultrasonographic evaluation of suprahyoid muscles may provide a non-invasive approach to describe structural changes associated with feeding maturation in preterm infants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known: &lt;/strong&gt;• The transition to full oral feeding in preterm infants reflects the maturation of multiple physiological systems, including suck-swallow-breathing coordination, and is a key determinant of discharge readiness. • Ultrasonography has been used as a non-invasive method to assess structural and functional aspects of muscles involved in feeding and swallowing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is new: &lt;/strong&gt;• Suprahyoid muscle thickness in preterm infants increases significantly from early postnatal life to full oral feeding and appears to cluster within a re","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of epicardial adipose tissue thickness and left ventricular functions in children with primary dyslipidemia.","authors":"Mohamed A Hassan, Mina Mamdouh, Faisal-Alkhateeb Ahmed, Khaled Mohammed Allam","doi":"10.1007/s00431-026-06997-1","DOIUrl":"https://doi.org/10.1007/s00431-026-06997-1","url":null,"abstract":"<p><p>Epicardial adipose tissue (EAT) is a component of visceral adiposity and mediates cardiac function and atherosclerosis via expression of several bioactive molecules. To evaluate the significance and relationship between epicardial fat thickness (EFT) and familial dyslipidemia and left ventricular function. This prospective case-control study was conducted at Assiut University Children's Hospital between September 2023 and August 2025. Twenty-one children with familial dyslipidemia and twenty-one age-, sex-, and BMI-matched healthy controls underwent clinical evaluation, lipid profile assessment, and transthoracic echocardiography, including measurement of epicardial fat thickness and left ventricular systolic and diastolic function according to American Society of Echocardiography guidelines. Dyslipidemic patients showed significantly higher total cholesterol (332.9 ± 222.3 mg/dL), triglycerides (391.4 ± 251.6 mg/dL), and LDL (154.3 ± 130.4 mg/dL) than controls (p < 0.001). Mixed hyperlipidemia was the most common type (47.6%). Echocardiography revealed increased epicardial fat thickness (2.88 ± 0.94 mm vs. 2.29 ± 0.57 mm; p = 0.018), larger left atrial (21.45 ± 3.86 mm; p = 0.031) and aortic diameters (17.54 ± 3.12 mm; p = 0.013). Triglyceride level was the only independent predictor of epicardial fat thickness (β = 0.437, p = 0.028).</p><p><strong>Conclusion: </strong> Echocardiography revealed increased epicardial fat thickness and early cardiac remodeling. Serum triglycerides were the only independent predictor of EFT, suggesting its key role in subclinical cardiovascular risk among dyslipidemic children.</p><p><strong>What is known: </strong>• Epicardial adipose tissue is associated with cardiovascular risk factors in adults. • Children with primary dyslipidemia may develop early cardiac dysfunction.</p><p><strong>What is new: </strong>• This study demonstrates a signifi cant association between epicardial adipose tissue thickness and left ventricular function in children. • It highlights the potential role of epicardial fat as an early marker of cardiac involvement in pediatric dyslipidemia.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}